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Lancet. 2014 Nov 15;384(9956):1789-99. doi: 10.1016/S0140-6736(14)61278-2. Epub 2014 Nov 14.

Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period.

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National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK. Electronic address:
National Institute of Mental Health and Neurosciences (NIMHNS), Bangalore, India.
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK.
Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK.


The perinatal period is associated with an increased risk of severe mental disorders. We summarise the evidence regarding the epidemiology, risk factors, and treatment of severe mental illness in relation to childbirth, focusing on bipolar disorder, affective psychosis, and schizophrenia. We discuss women with ongoing chronic conditions and those with the onset of new episodes of post-partum psychosis. Despite the importance of perinatal episodes, with suicide a leading cause of maternal death, few studies are available to guide the management of women with severe mental disorders in pregnancy and the post-partum period. However, general principles of management are discussed, including the need for an individual risk-benefit analysis for each woman.

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